Postpartum depression (PPD) is one of most common postnatal complications, affecting approximately 10%–15% of women after childbirth annually. Traditional Chinese medicine (TCM) has been gaining popularity as the choice of treatment for PPD in Taiwan. Hence, our aim was to analyze the utilization of TCM among PPD patients in Taiwan. A cross‐sectional study was conducted using a random sample of one million beneficiaries selected from the Taiwanese National Health Insurance Research Database. We identified patients with PPD who had received either TCM treatment or non‐TCM treatment from the database during 2000–2012. Multivariate logistic regression analysis was used to identify the factors associated with the use of TCM. A total of 653 patients with PPD were enrolled. The majority of patients with PPD were 26–30 years old, lived in a highly urbanized area of Taipei, had a monthly income <20,000 NT$, and were private enterprise employees. Around 52.7% of PPD patients had the motivation to seek TCM services. Younger women, who resided in central and southern Taiwan and who had used TCM one year before PPD diagnosis, were more likely to use TCM services. PPD patients who underwent TCM treatment had a lower overall medical expenditure than non‐TCM users. Most TCM users chose simple Chinese herbal medicine. The coexisting factors that made PPD patients to seek TCM services were respiratory or oral infections. We demonstrated the characteristics of those that seek TCM for PPD, which may provide useful insights to health care providers towards resource allocation.
6 January 2021 in Evidence-Based Complementary and Alternative Medicine
Background. Scutellaria baicalensis (SB), a traditional Chinese medicine, is commonly used for the treatment of inflammatory and painful conditions. The purpose of the present study was to examine the effects of SB on migraine. Materials and Methods. We examined the clinical applications of SB based on the data obtained from Taiwans National Health Insurance Research Database and confirmed that it was frequently used in Taiwan for the treatment of headaches. An experimental migraine model was established in rats by an intraperitoneal injection of nitroglycerin (NTG, 10mg/kg). Pretreatment with SB was given orally 30min before NTG administration. The rats were subjected to migraine-related behaviour tests that were video-recorded and analysed using EthoVision XT 12.0 software. Results. The frequency of exploratory and locomotor behaviour was comparatively lower in the NTG group than that in the control group, while the frequency of resting and grooming behaviour increased. These phenomena were ameliorated by pretreatment with 1.0g/kg SB. The total time spent on the smooth surface was longer in the NTG group than that in the control group, but the time was shortened by pretreatment with 1.0g/kg SB. Conclusions. Pretreatment with 1.0g/kg SB relieved migraine-related behaviours in the experimental NTG-induced migraine model. The outcome therefore demonstrated that pretreatment with 1.0g/kg SB is beneficial for migraine treatment.
1 December 2020 in Neuropsychiatric Disease and Treatment
Background: Existing evidence has shown that patients with trigeminal neuralgia (TN) have a higher risk of developing depression than the normal population. Clinically, acupuncture has been widely used to alleviate pain in TN. However, few studies have explored the use of acupuncture to prevent depression in TN. Therefore, this study aimed to apply national real-world data to investigate the long-term effect of acupuncture on the risk of depression in patients with TN. Methods: We recruited participants with newly diagnosed TN from the Taiwanese National Health Insurance Research Database between January 1, 2000 and December 31, 2010, and categorized them into either the acupuncture cohort or non-acupuncture cohort using the 1:1 propensity score-matched method. All patients in the two cohorts were followed up until the end of 2013. Cox proportional hazards regression analysis was used to compare the incidence of depression between the two cohorts. Results: In total, 776 patients with newly diagnosed TN in each cohort with similar baseline characteristics were enrolled in the study. The acupuncture cohort had a reduced risk of depression compared to the non-acupuncture cohort (adjusted hazard ratio, 0.47; 95% confidence interval, 0.31– 0.70). Kaplan–Meier analysis also revealed that the cumulative incidence of depression was significantly lower in the acupuncture cohort during the 13-year follow-up period (Log rank test, p < 0.001). In particular, the beneficial effect of acupuncture was a decrease in the risk of depression among TN patients aged 50– 69 years who had also used carbamazepine. Conclusion: This study demonstrated that acupuncture is associated with a reduction in the risk of depression during long-term follow-up in patients with TN. The results provide new insights for clinical practitioners as well as for health resource allocation.
Migraine is a complex neurovascular disorder in which immune signaling intersects with vascular and neural circuits, yet the tissue and cell-type context of common genetic risk remains incompletely defined. We integrated large-scale migraine genome-wide association study (GWAS) summary statistics with Genotype-Tissue Expression (GTEx) v8 expression and splicing quantitative trait loci (eQTLs and sQTLs), Bayesian co-localization, single-cell RNA sequencing of peripheral blood mononuclear cells (PBMCs) from migraine cases and controls, a healthy single-cell multi-omics atlas (assay for transposase-accessible chromatin (ATAC) plus RNA), high-dimensional weighted gene co-expression network analysis (hdWGCNA), and embryo-level spatial transcriptomics. Genetic signals were enriched in peripheral arteries, heart, and blood, and gene-level enrichment highlighted mucosal–smooth muscle organs including the bladder and the cervix endocervix. Cell-type prioritization consistently implicated endothelial and vascular smooth muscle lineages, with additional support for inhibitory interneurons and bladder epithelium. In PBMC T cells, co-expression modules capturing cytotoxic/activation and T-cell receptor signaling programs contained migraine-prioritized genes, including PTK2B, nominating immune activation circuitry as a component of genetic susceptibility. Spatial projection further localized risk concordance to craniofacial/meningeal interfaces and visceral smooth muscle–mucosal structures. Together, these analyses delineate a systemic neuroimmune–vascular architecture for migraine and provide genetically anchored candidate pathways and targets for mechanistic and therapeutic follow-up.